Next Article in Journal
Investigating the Role of Everolimus in mTOR Inhibition and Autophagy Promotion as a Potential Host-Directed Therapeutic Target in Mycobacterium tuberculosis Infection
Previous Article in Journal
The Relationship between Platelet Count and Host Gut Microbiota: A Population-Based Retrospective Cross-Sectional Study
Article Menu
Issue 2 (February) cover image

Export Article

Open AccessArticle
J. Clin. Med. 2019, 8(2), 231; https://doi.org/10.3390/jcm8020231

Effects of Stepwise Lung Recruitment Maneuvers in Patients with Early Acute Respiratory Distress Syndrome: A Prospective, Randomized, Controlled Trial

1
Department of Respiratory Therapy, Chi Mei Medical Center, Liouying, Tainan 73657, Taiwan
2
Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan
3
School of Medicine, College of Medicine, Fu Jen Catholic University, Xinzhuang Dist., New Taipei City 24205, Taiwan
4
Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan 73657, Taiwan
5
Division of Critical Care Medicine, Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
*
Author to whom correspondence should be addressed.
Both authors contributed equally to this work.
Received: 23 January 2019 / Revised: 31 January 2019 / Accepted: 6 February 2019 / Published: 10 February 2019
(This article belongs to the Section Pulmonology)
Full-Text   |   PDF [1030 KB, uploaded 22 February 2019]   |  

Abstract

Since the clinical benefit of lung recruitment maneuvers (LRMs) is still conflicting, we performed this prospective, randomized, controlled study to investigate whether LRMs should be used in the routine management of acute respiratory distress syndrome (ARDS). This trial was conducted in four intensive care units (ICUs) to compare application of a modified stepwise LRMs with solely lung-protective ventilation in patients with moderate to severe ARDS within 72 h from the onset. The primary outcome was 28-day mortality, and the secondary outcomes were ventilator-free days and ICU-free days. We collected data on 120 ARDS patients from 2009 to 2012, and there was no difference in 28-day mortality between the two groups (28.3% vs. 30.0%, p = 0.84). However, among survivors, patients in the LRM group had a significant longer median duration of ventilator-free days (18 vs. 13 days; p = 0.04) and ICU-free days (16 vs. 11 days; p = 0.03) at 28 days than in the control group. The respiratory system compliance was significantly higher in the LRM group from day 1 to day 7. The occurrence rate of barotrauma was similar in both groups. We concluded that LRMs combined with lung-protective ventilation in early ARDS may improve patient outcomes. View Full-Text
Keywords: acute respiratory distress syndrome; stepwise lung recruitment maneuver; ventilator-free days; ICU-free days acute respiratory distress syndrome; stepwise lung recruitment maneuver; ventilator-free days; ICU-free days
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Supplementary material

SciFeed

Share & Cite This Article

MDPI and ACS Style

Kung, S.-C.; Hung, Y.-L.; Chen, W.-L.; Wang, C.-M.; Chang, H.-C.; Liu, W.-L. Effects of Stepwise Lung Recruitment Maneuvers in Patients with Early Acute Respiratory Distress Syndrome: A Prospective, Randomized, Controlled Trial. J. Clin. Med. 2019, 8, 231.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top